WOMENS-HEALTH Messages for September, 2000: Re: VBAC at home???

Re: VBAC at home???

From: Debby (anonymous@obgyn.net)
Tue, 12 Sep 2000 23:01:33 -0500 (CDT)

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At Mon, 17 Jul 2000, jwang, M.D. wrote: >
>Ultimatley, the decision is the individual's to make, right or wrong. The advantage of hospital births is the if something does go wrong, help is immediately there. I can't imagine the guilt if something went wrong at home, and I as a parent had made that decision. Again, it is
>personal choice.

--
Jwang you are quite right in saying that ultimately the decision is the parents but it is the responsibility of all obstetricians, GPs and midwives to ensure that the decision made is an informed one not one based on emotive statements of presumed guilt in certain outcomes.
If you read the statistics, the mortality and morbidity rates in properly managed (ie by a midwife or doctor) home delivery, is no higher that for hospital births. As a mother who has had a hospital birth go wrong, through misinformation and over managment by my OB, because he didn't believe I needed to know my options (as I had no formal medical training), I can honestly say I felt a great deal of guilt by putting my son through fetal distress bought on by unnecessary oxytocin use and respritory distress from a ceasarean delivery. (Fortunately he suffered no long term effects).
I ensured I was educated for the birth of my second child and that he delivered in a safe manner. The first part of my labour was managed at home by a midwife and then after 32 hours of labour at 7cm dilation I chose to go to hospital where I laboured under the (remote) guidance of my OB (my midwife still with me) for another 12 hours. Healthy son, no fetal distress, intermitent monitoring and a very happy mother. My OB was a little dubious of my 'demands' during the pre natal stage however once he realised that I had read both sides of the risks assessments (ie those pro and against VBAC)he accepted that I was informed and allowed me to manage my own pregnancy with the guidance and advice of himself and my midwife. I now feel like I have been treated like an adult not like a silly child. All OBs, GPs and midwives should help their clients to reach this level of adult acceptance of responsibility by providing them with information that shows the variation in statistics and how VBAC delivery and other birthing issues compare in reality. Scare tactics, guilt trips and emotive argument diminish the reputation of the 'professional', they are tactics used by bullys in the school yard not by educated adults.

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